Potential side effects of surgery for penile cancer
Side effects can occur with any type of treatment for penile cancer, but not everyone has them or experiences them in the same way. Side effects of surgery will depend mainly on the:
- type of surgery
- person’s overall health
- effect of other cancer treatment
Side effects can happen any time during, immediately after, or a few days or weeks after surgery. Most side effects go away after surgery. Late side effects can occur months or years after surgery. Some side effects may last a long time or be permanent.
It is important to report side effects to the healthcare team.
Pain often occurs after surgery because of trauma to the tissue during surgery. It may take time for pain to go away after penile cancer surgery. The intensity of the pain will depend on the procedure, how the man heals and how well he tolerates pain. Pain-relieving medications are used to control pain. If pain does not go away or pain medicines do not relieve the pain, check with the doctor.
Some men may develop a wound infection after surgery. This is not a common side effect, but it can potentially occur after any type of surgery. Antibiotics may be used to help prevent or treat an infection. Wound infection is a temporary side effect of surgery.
Tell the doctor or healthcare team about signs of infection, such as redness, pus or foul-smelling drainage, increased swelling or tenderness at the treatment site and increased temperature (fever).
The edges of a wound are usually held in place with stitches until the incision heals. The edges of the wound may separate after surgery (dehiscence). Tell the doctor if this happens.
Bleeding or hemorrhage can occur if a blood vessel is not sealed off during surgery, or if the person has a blood clotting disorder. Nursing staff frequently check bandages and drains for heavy bleeding right after surgery. If bleeding occurs and is severe enough, the surgeon may have to take the person back to the operating room to find where bleeding is coming from and to stop it.
A small amount of bloody drainage may be expected after surgery. Report heavy bleeding to the doctor or healthcare team.
Bleeding can also happen after laser surgery, but it is less likely to occur than after conventional surgery.
Lymphedema is the swelling that occurs when lymph fluid builds up in the soft tissues of the limbs. It is caused by a problem in the movement (circulation) of lymph fluid away from a limb (arm or leg). Lymphedema may occur in the legs or scrotum if the lymph nodes in the groin are removed.
A seroma is a soft, puffy area of swelling caused by a collection of lymph fluid under the skin in the area of the surgical incision. Normally the lymph fluid flows through small tubes (lymph vessels) that connect the lymph nodes. During surgery, the lymph vessels are cut or removed, which causes the lymph fluid to collect in the area. Seroma is a common potential side effect of penile surgery and may happen after the surgical drains are removed.
Treatment for a seroma may include draining the fluid with a needle and syringe. Some men may need to have the seroma drained several times. In rare situations, surgery may be necessary to remove a seroma.
A blood clot in the legs is called a deep vein thrombosis (DVT). A DVT can occur right after surgery because the person cannot move around very well, along with other factors. In the most serious cases, a blood clot can break off and travel to the lungs (called a pulmonary embolus or PE). This causes shortness of breath and affects the blood’s ability to get oxygen from the lungs. Blood clots in the lungs can potentially cause heart failure.
Taking blood thinners (anti-coagulants) and applying compression stockings during and after surgery helps to prevent DVT and PE.
Report any redness, swelling, pain or cramps in the calf of the leg to the doctor or healthcare team.
A hematoma is an abnormal collection of blood outside of the blood vessels. It is caused by blood leaking from the blood vessels that were cut during surgery. It is an uncommon side effect of penectomy.
A hematoma may cause pain, redness, skin discoloration and swelling in the area around the incision. Most hematomas will slowly disappear with time, but large hematomas may take several weeks or months to go away. Treatment may include compression applied to the area, or draining the collected blood with a needle and syringe. Pain-relieving medications may be used to control pain.
Part of the urethra may narrow after a penectomy. A doctor will use a special technique to dilate the urethra. If the problem persists, a man can also be taught how to use a catheter to dilate the urethra himself.
Men who have had a total penectomy will need to have the urethra repositioned. The surgeon will make an opening between the anus and scrotum (called a perineal urethrostomy) so that the man can urinate. A man can still control urination because the muscle that keeps the bladder closed is further inside the body, above the penis. The man must urinate sitting down after surgery.
Surgical removal of the penis can change a man’s body image. This may cause concern and feelings of embarrassment. Helping men talk about their feelings and offering reconstruction, if it is an option, may help some men cope with altered body image.
Some men who have a partial penectomy can have an erection and ejaculate. Men who have a total penectomy cannot have an erection and penetrative intercourse is not possible. It may be possible for these men to have reconstructive surgery. There are also sexual health tips that may be helpful to men whose body image changes as a result of penile cancer surgery.
Skin reactions are a potential side effect of cryosurgery. Cryosurgery may cause the skin to blister and peel. Once the skin has healed, there may also be some scarring on the skin where the freezing was done.
A surgical technique that uses a laser (an intense beam of light) to make bloodless cuts in tissue.
Laser surgery may be used to remove abnormal tissue on the surface of an organ or the skin, remove blockages or stop bleeding.
A procedure that uses extreme cold (liquid nitrogen or liquid carbon dioxide) to freeze and destroy abnormal tissue.
Also called cryoablation, cryosurgical ablation or cryotherapy.